Analysis of the short-term and long-term effect of Er-yttrium aluminum garnet laser in stapes surgery

Abstract

To analyze the short-term and long-term effect of Er-yttrium aluminum garnet (Er-YAG) laser in stapes surgery. There were 86 patients operated by the Er-YAG laser stapedotomy from 2001 to 2007 were analyzed retrospectively, with 23 male, 63 female and 13 double ears and with the average age of 48 years old, ranging from 12 to 78. All of 99 ears suffered deafness of conduction. The average air-bone-gap (ABG) of all patients before surgery was (37.4+/-9.0) dB HL (ranging from 13.7 to 58.7 dB). The patients followed-up over 6 weeks after the surgery was regarded as the short-term result, while over one year follow-up as the long-term effect (according to the standard of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery). The followed-up average time was (26.3+/-15.8) months (range from 14 to 73 months). The pre-post-operation average bone conduction auditory threshold of 2 kHz and 4 kHz were observed. The data of the patient whether or not has the symptoms of tinnitus and dizzy and the lasted days were also recorded. After surgery, short-term ABG of 99 ears was (15.7+/-8.7) dB, matched-pairs t test with the numbers of before surgery, t=22.79, P<0.01. The results of 45 ears (45.5%) with ABG<10 dB or air conduction improved more than 30 dB were regarded as excellence. The air conduction of 88 ears (88.9%) improved more than 15 dB was regarded as utility. With 82 ears (82.8%) followed-up more than 1 year, the average ABG was (11.7+/-6.8) dB, matched-pairs t test with the numbers of before surgery, t=23.37, P<0.01, compared with the short-term visit result [(15.3+/-9.2) dB, 82 ears], t=4.82, P<0.01, both of which were considered statistically extremely significant. Among them, 50 ears (61.0%) have the excellent effect while 74 ears with (90.2%) ABG<20 dB. The average bone conduction auditory threshold in 2 kHz was (34.5+/-15.0) dB before surgery, matched-pairs t test with short-term visit result (33.4+/-15.9) dB, t=1.96, P=0.026 14, with long-term visit result (32.7+/-15.2) dB, t=3.24, P=0.000 87, all of which had the significant difference, manifest that the Cohort's notch had been improved after the surgery. The data of bone conduction auditory threshold of 4 kHz with long-term following-up result matched-pairs t test with that of surgery before, t=0.76 (P>0.05), which showed the change of the bone conduction had no statistics difference. There were 55 ears had the persistent tinnitus before surgery, in which 42 ears (76.4%) with no the tinnitus, 13 ears with same to that of preoperative, and 3 ears (3.0%) with remaining tinnitus after surgery but who had not it preoperation and all disappeared after 2 - 3 days. There were 12 ears (12.1%) with light dizzy after surgery, but their live could deal with himself and the average dizzy lasted 2.3 days. Er-YAG laser stapes surgery is safe to the inner ear, and it primal free from the imminent risk in stapes surgery, so the effect can be affirmed.